Results From a Randomized Trial of Intensive Glucose Management Using CGM Versus Usual Care in Hospitalized Adults With Type 2 Diabetes: The TIGHT Study.

OBJECTIVE: To evaluate whether continuous glucose monitoring (CGM) could assist providers in intensifying glycemic management in hospitalized patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: At six academic hospitals, adults with type 2 diabetes hospitalized in a non-intensive care setting were randomly assigned to either standard therapy with glucose target 140-180 mg/dL (standard group) or intensive therapy with glucose target 90-130 mg/dL guided by CGM (intensive group). The primary outcome was mean glucose measured with CGM (blinded in standard group), and the key secondary outcome was CGM glucose <54 mg/dL. RESULTS: For the 110 participants included in the primary analysis, mean ± SD age was 61 ± 12 years and mean HbA1c was 8.9 ± 2.3% (73.8 ± 1.6 mmol/mol). During the study, CGM-measured mean glucose was 170 mg/dL for the intensive group (n = 60) vs. 175 mg/dL for the standard group (n = 50; risk-adjusted difference -7 mg/dL, 95% CI -19 to 5; P = 0.25). Only 7% of the intensive group achieved the mean glucose target range of 90-130 mg/dL. CGM readings <54 mg/dL were infrequent (0.2% for intensive and 0.4% for standard; adjusted treatment group difference -0.1%, 95% CI -0.6 to 0.3). One severe hypoglycemia event occurred in the standard group. CONCLUSIONS: The study's glucose management approach using CGM did not improve glucose levels compared with standard glucose management in the non-intensive care unit hospital setting. A glucose target of 90-130 mg/dL may not be realistic in the current environment of insulin management in the hospital.

Authors

Institutions

Publication Details

Journal
UNC Libraries
Published
2024-12-04
DOI
https://doi.org/10.17615/bxnt-0j02
Primary Topic
Hyperglycemia and glycemic control in critically ill and hospitalized patients
Type
article
Field-Weighted Citation Impact
0.00

Funders

Controls
|||
ALL TIME
JAN
FEB
MAR
APR
MAY
JUN
JUL
AUG
SEP
OCT
article

Results From a Randomized Trial of Intensive Glucose Management Using CGM Versus Usual Care in Hospitalized Adults With Type 2 Diabetes: The TIGHT Study.

Jing H. Chao, Karla Fulghum, Shari L. Reynolds, Bobak Moazzami et al.
UNC Libraries
Hyperglycemia and glycemic control in critically ill and hospitalized patients
article

Results From a Randomized Trial of Intensive Glucose Management Using CGM Versus Usual Care in Hospitalized Adults With Type 2 Diabetes: The TIGHT Study.

Jing H. Chao, Karla Fulghum, Shari L. Reynolds, Bobak Moazzami, Georgia M. Davis, Jesica D. Baran, Irl B. Hirsch, Dan Raghinaru, Dori Khakpour, John B. Buse, Judy Sibayan, Boris Draznin, Cecilia C. Low Wang, Stacey Seggelke, Priyathama Vellanki, Guillermo E. Umpierrez, William H. Scott, Brooke C. Matson, April Goley, Jamie Diner, Francisco J. Pasquel, Jennifer Vinh, Zohyra E. Zabala, Alex Kass, Nikola Gligorijevic, Erin E. Kershaw, Becky Alexander, Chase Armstrong, Elias K. Spanakis, Klara R. Klein, Ashish Garg, Lakshmi G. Singh, Jagdeesh Ullal, Morgan Jones, Craig Kollman, THE PARA STUDY GROUP, M. Huang, Monica Y. Choe, Roy W. Beck, Wanda Ferrara, Faryal Gilani, Jade Churchill, Joseph O. Monye, Rajlaxmi Bais, Whitney B. Adair, Palak Choksi, Charles Spanbauer
article en

Abstract

OBJECTIVE: To evaluate whether continuous glucose monitoring (CGM) could assist providers in intensifying glycemic management in hospitalized patients with type 2 diabetes. RESEARCH DESIGN AND METHODS: At six academic hospitals, adults with type 2 diabetes hospitalized in a non-intensive care setting were randomly assigned to either standard therapy with glucose target 140-180 mg/dL (standard group) or intensive therapy with glucose target 90-130 mg/dL guided by CGM (intensive group). The primary outcome was mean glucose measured with CGM (blinded in standard group), and the key secondary outcome was CGM glucose <54 mg/dL. RESULTS: For the 110 participants included in the primary analysis, mean ± SD age was 61 ± 12 years and mean HbA1c was 8.9 ± 2.3% (73.8 ± 1.6 mmol/mol). During the study, CGM-measured mean glucose was 170 mg/dL for the intensive group (n = 60) vs. 175 mg/dL for the standard group (n = 50; risk-adjusted difference -7 mg/dL, 95% CI -19 to 5; P = 0.25). Only 7% of the intensive group achieved the mean glucose target range of 90-130 mg/dL. CGM readings <54 mg/dL were infrequent (0.2% for intensive and 0.4% for standard; adjusted treatment group difference -0.1%, 95% CI -0.6 to 0.3). One severe hypoglycemia event occurred in the standard group. CONCLUSIONS: The study's glucose management approach using CGM did not improve glucose levels compared with standard glucose management in the non-intensive care unit hospital setting. A glucose target of 90-130 mg/dL may not be realistic in the current environment of insulin management in the hospital.

UNC Libraries
University of North Carolina at Chapel Hill (US)
U.S. Department of Veterans Affairs, Eli Lilly and Company, Pfizer, AstraZeneca, Sanofi, Emory University, Regeneron Pharmaceuticals, Vertex Pharmaceuticals, Bigfoot Biomedical, Insulet Corporation, MannKind Corporation, Dexcom, Tandem Diabetes Care, Moderna, Novo Nordisk, National Institutes of Health, University of North Carolina at Chapel Hill, Abbott Diabetes Care, National Institute of Diabetes and Digestive and Kidney Diseases, National Center for Research Resources, National Center for Advancing Translational Sciences
Zero hunger
Openalex Percentile: Top 65%
Hyperglycemia and glycemic control in critically ill and hospitalized patients
DOIOpen Access PDFOpenAlex
AI Navigator

Ask Laika to Summarize, Analyze, and Connect papers live on the map.

Summarize Papers & Methodologies

Extract key findings, datasets, and comparative methods across publications.

Benchmark Rankings & Visual Analytics

Rank top research institutions, authors, funders, topics, and journals by Field-Weighted Citation Impact (FWCI) and paper volume with instant charts.

Connect Distant Disciplines

Bridge topological clusters on the map to find hidden collaborative intersections.